On July 10, 1980, the U.S. District Court for the Southern District of New
York entered an Amended Order and Final Judgment setting forth certain
notice and processing time requirements for Supplemental Security Income
(SSI) claims by New York State residents who request ALJ hearings. That
order also required payment of interim benefits in certain cases when the
court-ordered processing time deadlines were not met.

On March 6, 1990, the court entered a Second Amended Order and Final
Judgment which amended certain aspects of the July 10, 1980 order. OHA
implemented the March 6, 1990 order in memoranda dated August 17, 22, 27
and 30 and November 9, 1990, from the Regional Chief ALJ for Region
II.

In 1978, the U.S. District Court for the Eastern District of New York
issued orders prescribing time limits for holding hearings in title II
disability claims by New York State residents. The orders mandated the
payment of interim benefits if the time limits were not met and
established requirements for monitoring compliance. On May 28, 1985, the
court vacated its previous orders granting class-wide relief, but
indicated that it intended to order alternate class-wide relief in the
form of a notice. On April 24, 1986, the court ordered the Secretary to
send a specific notice to all class members at the same time OHA
acknowledges receipt of a claimant's request for hearing. On June 10,
1986, the Regional Chief ALJ for Region II issued a memorandum directing
all New York hearing offices (HOs) to implement the court's order.

are awaiting either the holding of their hearings, the issuance of
decisions, or effectuation of favorable decisions.

EXCEPTIONS:

A person is not a Sharpe class member if

(1) he or she is a Martinez class member by
virtue of a concurrent claim for disability benefits under titles II and
XVI; or

(2) he or she has been verified with the New York State Department of
Social Services, or the appropriate local agency, to be receiving Interim
Assistance benefits from the State of New York.

NOTE:

In New York State, the Interim Assistance benefit consists solely
of home relief public assistance benefits; it does not include
public assistance from Aid to Families with Dependant Children (AFDC).
The HO may identify claimants as Interim Assistance recipients through
evidence or statements already in file, hearing testimony or through an
SSI2 query requesting the MPMT (miscellaneous payment data segment). An
entry of GRC (grant reimbursement and state and county code) in the MPMT
segment followed by a five-digit code beginning with 33 indicates receipt
of Interim Assistance from New York State. (Program Operations Manual
System (POMS) chapter
SI
02003.000 provides more details on Interim Assistance
Reimbursements.)

Because Interim Assistance recipients are not
Sharpe class members, it is not necessary to send
them any of the court ordered notices and they are not subject to the
interim benefit procedures in Part VI. A. below.

The Sharpe order requires the Secretary to issue
decisions to class members within 90 days for non-disability issue
cases and “within a reasonable time” for disability issue
cases. The order specifies certain extensions and exceptions to the
90-day time limit for non-disability issue cases as described below.

If the claimant or representative reports that either is not available on
the date for which a hearing is scheduled, the H0 must reschedule the
hearing for a date within 45 days after the ALJ is informed that the
claimant or the representative (if there is one) becomes available for a
hearing. If no hearings are scheduled to be held in the area of the
claimant's residence within the 45-day period, the HO will reschedule the
hearing for the next hearing trip the ALJ makes to the area of the
claimant's residence. However, if the claimant is willing to travel to the
HO, the HO must schedule the hearing within the 45-day time limit. In the
event of a claimant-requested postponement under this provision, the time
limit for issuing a decision is extended by the length of time between
the date that the hearing was originally scheduled and the date for which
the hearing is rescheduled.

If the ALJ requests additional evidence before the hearing, he or she must
do so within 45 days after the request for hearing is filed. The ALJ must
hold a hearing within 30 days after receiving the additional evidence. In
the event of a pre-hearing request for evidence under this provision, the
time limit for issuing a decision is extended by the length of time
between the date that the ALJ requests the additional evidence and the
date such evidence is received.

If the claimant requests additional time to submit more evidence, or to
obtain witnesses or representation, the time period for issuing a decision
is extended by a period not to exceed the additional time granted.

If the ALJ cannot hold the hearing within the timeframes specified above
because of uncontrollable circumstances, e.g., natural catastrophe or the
unexpected illness of the ALJ, the ALJ may ask the Regional Chief ALJ for
an extension of time of up to 30 days. Excessive workload cannot
constitute an uncontrollable circumstance. In the event that such an
extension is granted, the time limit for issuing a decision is extended by
the length of the extension granted.

If the ALJ cannot issue a decision within the time required by the court
because of uncontrollable circumstances, e.g., natural catastrophe or the
unexpected illness of the ALJ, the ALJ may ask the Regional Chief ALJ for
an extension of time of up to 30 days. Excessive workload cannot
constitute an uncontrollable circumstance. In the event that such an
extension is granted, the time limit for issuing a decision is extended by
the length of the extension granted. If the Regional Chief ALJ denies the
request for extension, the ALJ must issue the decision within 5 working
days following the denial of the request for extension.

If the ALJ requests additional evidence after the hearing, he or she must
request it within 30 days after the hearing is held. The ALJ must issue
the decision within 30 days after the additional evidence is received and
the period for comment has ended (see b. below if a supplemental hearing
is needed).

If the claimant wishes to submit additional evidence or written statements
of fact and law, the ALJ must issue the decision within 30 days of
receiving the additional evidence.

If, on the basis of additional evidence, the ALJ decides that a
supplemental hearing is necessary, the ALJ must hold the hearing within 30
days of receiving the additional evidence, and must issue a decision
within 30 days after holding the supplemental hearing.

If, after a hearing has been held, it is necessary to reassign a case to
another ALJ because the original ALJ is unavailable, e.g., through
resignation, retirement or illness, the Hearing Office Chief ALJ must
reassign the case within 30 days of the date the Regional Chief ALJ learns
of the unavailability. The new ALJ must issue a decision within 30 days
of the reassignment unless another extension or exception applies, e.g.,
a new hearing may be required (see HALLEX
I-2-8-40).

The 1985 and 1986 Martinez orders eliminated all
specific processing time deadlines for Martinez
class members. However, Martinez class members
may seek judicial relief if they believe their claims are being
“unreasonably delayed.” The court ordered acknowledgment
notice that the HOs must send to all class members describes how claimants
can determine the status of their claims and the procedures available if
they believe there has been an unreasonable delay (see Part V. B.
below).

In all title XVI disability issue class member cases in which a
hearing has not been held or a decision rendered within 120 days after
the date the claimant files a request for hearing, the HO must send the
individualized notice contained in Exhibit A of the court's order
(see Attachment 1) to the claimant, with a copy to the claimant's
representative, if any. The HO must also send copies of all Exhibit A
notices to counsel for the Sharpe class at the
address shown on that attachment. The notice must contain an
individualized explanation of why SSA has not yet held a hearing or issued
a decision. To the extent applicable, the individualized explanation
should indicate which of the extensions or exceptions listed in Part
IV. A. above apply. The notice must contain the address(es) of the
appropriate U.S. District Court and the pro se clerk's telephone number,
which can be determined from the list in Attachment 2. The HO must
mail the Exhibit A notice 120 days after the request for hearing is filed
or within 10 days thereafter.

NOTE:

The 10-day period for mailing the Exhibit A notices cannot be extended
(i.e, the exceptions and extensions in Part IV. A. above do not
apply to the mailing of notices.)

In all title XVI non-disability issue class member cases in which
a hearing has not been held or a decision rendered within 90 days after
the date the claimant files a request for hearing, and the Secretary will
not be paying interim benefits as explained in Part VI. A.
below, the HO must send the individualized notice contained in
Exhibit B of the court's order (see Attachment 3) to the claimant,
with a copy to the claimant's representative, if any. The HO must also
send copies of all Exhibit B notices to counsel for the
Sharpe class at the address shown on that
exhibit. The notice must contain an individualized explanation of why SSA
has not yet held a hearing or issued a decision. The individualized
explanation should indicate which of the extensions or exceptions listed
in Part IV. A. above apply. (If none applies, the Exhibit B notice
is inappropriate and the HO must initiate interim benefits -- see
Part VI. A. below.) The notice must contain the address(es) of the
appropriate U.S. District Court and the pro se clerk's telephone number,
which can be determined from the list in Attachment 2. The HO must
mail the Exhibit B notice 90 days after the request for hearing is filed
or within 10 days thereafter.

NOTE:

The 10-day period for mailing the Exhibit B notices cannot be extended
(i.e., the exceptions and extensions in Part IV. A. above do not
apply to the mailing of notices.)

In all title XVI non-disability issue class member cases in which
the Secretary will be paying interim benefits as explained in
Part VI. A. below, the HO must send the notice contained in
Exhibit C of the court's order (see Attachment 4) to the claimant,
with a copy to the claimant's representative, if any. (Although the
notice contains the Social Security field office address, the HO will
prepare and release it.) This notice advises the claimant that he or she
will receive prospective interim benefits until a decision is issued. The
HO must mail the Exhibit C notice 90 days after the request for hearing
is filed or within 10 days thereafter.

In all title XVI class member cases, both disability and
non-disability issue cases, in which an ALJ issues a fully or
partially favorable decision, the HO must send the claimant the
notice contained in Exhibit D of the court's order (see
Attachment 5) with the claimant's copy of the decision. The HO must also
send a copy to the claimant's representative, if any, and to the
Sharpe class counsel.

In Exhibit D, the HO must indicate the appropriate time limits which apply
to calculation and payment of SSI payment amounts. If the ALJ's decision
does not address all elements of SSI eligibility (e.g.,
income, resources,and residency) for the entire period on which
the ALJ rules favorably, the Exhibit D notice must reflect a 60-day time
limit for calculation of benefit amounts and a 75-day time limit for
payment of benefits. If the ALJ's decision does address all elements of
SSI eligibility for the entire period on which the ALJ rules favorably,
the time limits are 20 days for calculation of benefits and 35 days for
payment.

In all title II and title II/title XVI concurrent disability claims, the
HO must advise the claimant, and representative, if any, of the claimant's
right to petition the district court for relief, including interim
benefits, if he or she believes his or her case is being unreasonably
delayed. The HO must do this at the time it acknowledges receipt of the
claimant's request for hearing, either by including the Attachment 6
language in the acknowledgment notice, or by including a separate notice
containing Attachment 6 language with the acknowledgement letter when it
is sent.

The Sharpe order requires the Secretary to pay
interim benefits in all title XVI non-disability class member
cases in which a decision has not been issued within 90 days after the
date the claimant files a request for hearing, subject to any of the time
extensions or exceptions listed in Part IV. A. above. If the 90
days expire on or before the fifteenth day of the month, entitlement to
interim benefits is effective as of the first day of that month. If the
90 days expire after the fifteenth of the month, entitlement is effective
as of the first day of the following month.

The HO must monitor Sharpe cases to ensure that
the HO timely requests payment of benefits when appropriate. The HO must
initiate interim benefits within the same 90 to 100-day timeframe for
mailing the Exhibit C notice (Attachment 4) as described in Part V. A.
3. above.

To initiate interim benefits, the HO must send a memorandum, via E-Mail,
to the Regional Chief ALJ, Region II, with a copy to the Regional
Commissioner. The Regional Commissioner's E-Mail address is:

¦¦NY ARC POS RSI/SSI BRANCH

The memorandum should contain the following information:

Subject: Sharpe Case Requiring Interim Benefits

Claimant:Social Security Number:ALJ Name and Code:DO Code:Start Date:

If the claimant is already in payment status, do not initiate interim
benefits. Instead, send the claimant an Exhibit B notice explaining the
reason(s) for the delay and advising that no interim benefits are payable
because he or she is already receiving benefits.

When the ALJ issues a decision, send another E-Mail memorandum to the
Regional Chief ALJ, with a copy to the Regional Commissioner, repeating
the above information and indicating the following:

Stop Date:

Date of Decision:

Type of Decision:

No interim benefits are payable before the issuance of an ALJ
decision in disability issue cases.

The Sharpe order provides that the Secretary must
pay interim benefits after a favorable ALJ decision is issued,
for both disability and non-disability issue claims, if effectuation of
benefits is not made within the time limits spelled out in the order. SSA
field offices initiate these payments through the Regional Commissioner's
Office and advise the claimant using the notice contained in Exhibit E of
the court's order (Attachment 7).

OHA's only involvement is to send the Exhibit D notice discussed above,
advising the claimant of the applicable timeframes.

The Sharpe order requires the Secretary to submit
certain processing time reports on a quarterly basis. All HOs handling
claims from residents of New York State must use the Hearing Office
Tracking System (HOTS) program furnished by the Regional Office to
identify Sharpe cases and to gather the required
statistics. The HOs must submit quarterly reports to the Regional Office
by the third Friday following the end of each calendar quarter.

HO personnel should direct any questions to their Regional Office.
Regional Office personnel should contact the Division of Field Practices
and Procedures in the Office of the Chief Administrative Law Judge at
(703) 305-0022. Headquarters personnel should contact the Division of
Litigation Analysis and Implementation in the Office of Policy, Planning
and Evaluation at 305-0724.

You requested a hearing before an Administrative Law Judge on
[Insert request for hearing date.], over 120 days ago. We
have not yet [scheduled your hearing/issued a decision after your
hearing] because [Insert detailed reason(s).].

If you want more information concerning the status of your case or if you
want us to act more quickly on your case, you may call or write to us at
the above phone number and address. Ask to speak to a [hearing
assistant/hearing clerk].

Your hearing is about whether you are disabled, and you have the right to
a hearing and decision within a reasonable time after your hearing
request. You have this right because of a federal district court order in
Sharpe v. Sullivan, 79 Civ. 1977 (CSH)
(S.D.N.Y.).

The court order in Sharpe does not require us to
pay you benefits while we decide your case (“interim
benefits”). However, if you believe that there has been an
unreasonable delay in your case, you may seek help in the United States
District Court for the [Northern/Southern/Eastern/Western]
District of New York. You may make a motion to the judge for an Order
directing us to provide your hearing and/or decision promptly and to pay
you interim benefits until we do this. The Court is located at the
following location(s):

[See Attachment 2 for a list of district court addresses and pro se
clerk telephone numbers.]

If you need help making this motion in court, there are “pro
se” clerks in the Courthouse to assist you. The “pro
se” clerk's telephone number is listed in the above paragraph.

You may also wish to consult an attorney about your rights. Free legal
services may be available if you qualify for them due to financial
need.

A list of attorneys who may be able to provide free services is
attached.

Administrative Law Judge

cc: The Legal Aid Society Civil Appeals Law
Reform UnitSharpe
Compliance 11 Park Place
New York, New York 10007
[Representative's name & address]

You requested a hearing before an Administrative Law Judge on
[Insert request for hearing date.], over 90 days ago.

Your hearing does not involve a disability issue, and therefore you have
the right under the Social Security Act to a hearing and a decision within
90 days after your hearing request. Under a federal district court order
in Sharpe v. Sullivan, 79 Civ. 1977 (CSH)
(S.D.N.Y.), we are required to pay interim benefits to claimants to whom
we have not issued a hearing decision within 90 days after a hearing
request. However, under the order, we do not have to pay interim benefits
when certain special exceptions apply.

We believe that we are not required to pay you interim benefits at this
time because of the following special exception(s) that applies(apply) to
your case: [Insert explanation, referring to all applicable
exceptions and extensions. See Part IV. A.]

If you want more information concerning the status of your case or if you
want us to act more quickly on your case, you may call or write to us at
the above phone number and address. Ask to speak to a [hearing
assistant/hearing office clerk].

If you believe that we have unreasonably delayed your case, you have a
right to seek help in the United States District Court for the
[Northern/Southern/Eastern/Western] District of New York.
You may make a motion to a judge for an Order directing us to provide
your hearing and/or decision promptly and to pay you benefits
(“interim benefits”) while we do this. The Court is located
at the following location(s):

[See Attachment 2 for a list of district court addresses and pro se
clerk telephone numbers.]

If you need help making this motion in court, there are “pro
se” clerks in the Courthouse to assist you. The “pro
se” clerk's telephone number is listed in the above paragraph.

You may also wish to consult an attorney about your rights. Free legal
services may be available if you qualify for them due to financial
need.

A list of attorneys who may be able to provide free services is
attached.

Administrative Law Judge

Attachment

cc: The Legal Aid Society Civil Appeals Law
Reform UnitSharpe
Compliance 11 Park Place
New York, New York 10007
[Representative's name & address]

Because your Supplemental Security Income (SSI) case does not involve a
disability issue, the Social Security Administration is generally required
to issue a decision after hearing within 90 days after your hearing
request is filed. Because we have not decided your claim within this time
limit, we will shortly begin sending you special interim benefit payments.
These payments are required under a federal district court order in
Sharpe v. Sullivan, 79 Civ. 1977 (CSH)
(S.D.N.Y.).

If you do not begin to receive your special interim benefit payments
within two weeks of the date of this letter, you may call a claims
representative at our toll free number,

1-800-772-1213. You may also call this number if you do not wish to
receive these special interim payments while awaiting a decision in your
case.

Please keep the following in mind:

1. If you receive a favorable decision after
hearing, you will stop receiving special interim benefits and will begin
receiving your regular benefits.

If we learn that the amount of the special interim benefits we paid to you
is higher than the regular benefits you should have received for the same
time period, we will decide that you were overpaid. In that case, we will
mail you a written notice that explains how we computed the overpayment,
how we will collect the overpayment, and how you may appeal our decision
that you were overpaid. The notice will also tell you how you may request
a waiver of the overpayment. If we agree to waive the overpayment, we will
not take any steps to collect the overpaid amount from you.

If, on the other hand, we learn that the amount of the special interim
benefits we paid you is lower than the regular benefit amount you should
have received for the same time period, we will promptly pay you the
amount by which you were underpaid and send you a written notice that
explains how the underpayment was computed.

2. If you receive an unfavorable decision after hearing,
your special interim benefit payments will stop, and the special interim
benefit payments you have received will be considered an overpayment. You
will have all the rights described above, including the right to appeal
our decision and to ask us to waive recovery of the overpayment.

Field Office Manager

Attachment

cc: The Legal Aid Society Civil Appeals Law
Reform UnitSharpe
Compliance 11 Park Place
New York, New York 10007
[Representative's name & address]

As the enclosed Administrative Law Judge hearing decision explains, we
have found that you are eligible to receive Supplemental Security Income
payments.

We will calculate your current and retroactive monthly benefit amounts
within [60 days/20 days because we do not need more information on
your financial eligibility] and we will send you your current and
retroactive benefits within [75/35] days unless special
exceptions apply. You have the right to prompt payment of your benefits
because of a federal district court order in
Sharpe v. Sullivan, 79 Civ. 1977 (CSH)
(S.D.N.Y.).

If you have any questions or need additional information, please call our
toll free number 1-800-772-1213 and ask for a claims representative.

Administrative Law Judge

Attachment

cc: The Legal Aid Society Civil Appeals Law
Reform UnitSharpe
Compliance 11 Park Place
New York, New York 10007
[Representative's name & address]

We have received your request for a hearing and we will notify you at
least 20 days before the hearing as to when and where it will be held.
Although we will make every effort to schedule you as soon as possible,
there may be a delay in scheduling your hearing. If you wish to find out
anything else about the status of your case, you may call or write to us
at the above listed address.

We are required by district court opinion, dated May 28, 1985, in
Martinez, et al. v. Secretary of HHS,
E.D.N.Y., No. 73 Civ. 900, to notify you of procedures available to you in
the event of unreasonable delay in processing your case. If, after
requesting a status report of your case, as explained above, you believe
your case is being delayed unreasonably, you may apply to the United
States District Court for relief, including interim benefits, if
appropriate. You may wish to consult an attorney regarding your rights.
Free legal services may be available if you qualify for them due to
financial need.

A list of attorneys, who may be able to provide free services, is
attached.

With your Supplemental Security Income (SSI) hearing decision, we sent you
a letter saying that your regular and retroactive benefit amounts would
be calculated within (60 days/20 days because we do not need more
information about your financial eligibility) [cross out one]
of the decision and that you should receive your regular and retroactive
benefits within (75 days/35 days) [cross out one] of the
decision, unless special exceptions apply.

Because we have not calculated the amount of your regular SSI benefits
within this time limit, we will shortly begin sending you interim
payments. The amount we pay you will be our best estimate of your regular
benefit amount. These interim payments will continue until we compute the
correct amount of your SSI benefits and begin to pay you that amount.
These payments are being made under a federal district court order in
Sharpe v. Sullivan, 79 Civ. 1977 (CSH)
(S.D.N.Y.).

We will continue to pay you a monthly interim benefit check until we
actually calculate and send you your regular monthly benefits. When we
make this calculation, we may learn that the amount of interim benefits
that we paid to you is either higher or lower than the regular benefits
due you for the same time period.

If at that time we decide that the amount of the interim benefits you were
paid is higher than your regular benefit amount, we will decide
that you were overpaid and will mail you a written notice that explains
how we computed the overpayment, how we will seek to collect the
overpayment, and how you may appeal our overpayment determination. The
notice will also tell you how you may request a waiver of the
overpayment. If we agree to waive the overpayment, we will not take any
steps to collect the overpaid amount from you.

However, if at that time we decide that the amount of the interim benefits
you received is lower than the amount you should have received,
we will promptly pay you the amount by which you were underpaid. We will
also send you a written notice that explains how the underpayment was
computed.

If you do not begin to receive these special interim payments within two
weeks of the date of this letter, or do not wish to receive them, you may
call a claims representative at ____________.

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